HomeMy WebLinkAbout812 W 15th St - Building
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
property Address
ASSESSOR PARCEL NUMBER:
Application description
property Zoning . . .
Application valuation .
03-00000153
812 W 15TH ST
0630000428100000
RE-ROOF
Date
2/19/03
1250
OWner
Contractor
LILIENTHAL MARILYN K
812 W 15TH ST
PORT ANGELES WA 983637228
OWNER
Permit BUILDING PERMIT NO PR FEE
Additional desc
Permit Fee 71.40 Plan Check Fee
Issue Date 2/19/03 Valuation
Expiration Date 8/18/03
.00
1250
Qty Unit Charge Per
8.00 3.0500 HND
BASE FEE
BL-501-2K (3.05 PER C)
Extension
47.00
24.40
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Other Fees
STATE SURCHARGE
4.50
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ----------
----------
Permit Fee Total 71. 40 71. 40 .00 .00
plan Check Total .00 .00 .00
.00
Other Fee Total 4.50 4.50 .00
.00
Grand Total 75.90 75.90 .00
.00
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Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work as commenced, orif required inspections have not been requested within 180 days from the last
inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
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Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is buiider) Date
T:\PLANNING\FORMS\1102.15 [412002J
BUILDING PERMIT - APPLICATION
FOR OFFICIAL USE ONLY:
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Permlt#: f~... S
Date Approved:
Date Issued:
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Applicant or Agent: Dl"r(" 5 Phone: - <'. - (~
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(VI c>, ,- I L, lie.'1 Hl q I Phone: ,+"7- - 3 :>6' (
Owner: I V'\ -' -
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Address: J.:o City: ~.-' . _J:" Zip:
The Building Permit Application must bejilled out completely.
Please type or print in ink. If you have any questions, please call 417-4815
Architect/Engineer:
Contractor
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License #:
Address:
City:
PROJECT ADDRESS:
LEGAL DESCRIPTION: Lot: Block:
CLALLAM COUNTY PARCEL NUMBER:
Billing Address:
Credit Card #:
Subdivision:
Credit Card Holder Name:
City:
Exp. Date: VISA
MC
SIZEN ALUATION:
SF. @ $ /SF. =.$
SF. @ $ /SF. = $
SF. @ $ /SF. = $'
TOTAL VALUATION $
re.-F.li
TYPE OF WORK:
:P( Residential 0 New Constr.
o Multi-family 0 Addition
o Commercial 0 Remodel
o Repair
;&. Re-roof
o Move
o Demolition
o Sign
o Wood-stove
o Garage
o Deck
o
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BRIEF DESCRIPTION OF THE PROJECT:
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COMMERCIAL/RESIDENTIAL: Occupancy Group:
Occupant Load:
Construction Type:
No. of Stories: Lot Size:
Existing Lot Coverage:
PLANNING USE ONLY:
Notes:
/sq. ft. ~ TOTAL LOT COVERAGE:
APPROVALS: PLAN
BLDG.
DPW
FIRE
ESNWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: OTHER
BUILDING PERMIT APPLICATION SUBMITTAL: Your application and site plan must be jilled out completely to be accepted for
review. The Building Division can provide you with more detailed information on the application and plan submittal requirements. Your
completed application, site plan (for additions) and building construction plans are to be submitted to the Building Division.
% Lot Coverage:
/sq. ft. + Proposed Lot Coverage:
%
/sq. ft.
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed
and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417 -4815 for assistance.
PLAN CHECK FEE: Your plan check fee is due at the time the building permit application and construction plans are submitted. All other
permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: Ifno permit is issued within 180 days of the date ofapplication, this application will expire. The
Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section 107.4 of
the Uniform Building Code, current edition). No application can be extended more than once.
I hereby certify that I have read and examined this application and know the same to be true and correct, and I am authorized to apply for
this permit. I understand it is not the City's legal responsibility to determine what permits are required; it remains the applicant's
responsibility to determine what permits are required and to obtain such.
Applicant: ~/(1 (; -:-..........::
.
Date:
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T:\FORMS\APPS\Buildingpermit